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Fakultas Kedokteran Universitas Brawijaya Gedung Graha Medika Lt. 1, Ruang 104
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INDONESIA
Jurnal Kedokteran Brawijaya
Published by Universitas Brawijaya
ISSN : 02169347     EISSN : 23380772     DOI : http://dx.doi.org/10.21776/ub.jkb
Core Subject : Health,
Medicine & Pharmacology
JKB contains articles from research that focus on basic medicine, clinical medicine, epidemiology, and preventive medicine (social medicine).
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 822 Documents
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The Implementation of the Seven-Rights Procedure in Drug administration in a Hospital Inpatient Room: the Inhibiting Factors and Alternative Solutions Puspitasari, Shinta Dwi; Dewanto, Aryo; Holipah, Holipah Holipah; Muliawan, Arrasyid Indra
Jurnal Kedokteran Brawijaya Article in Press 2
Publisher : Fakultas Kedokteran Universitas Brawijaya

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Abstract

Medication error becomes one of the main concerns in ensuring patient safety worldwide. In the first semester of 2020, Hospital X reported two incidents of medication error. Although the incidents were categorised as “adverse event” and “near miss”, it should have been prevented. One of the methods to prevent medication error is the application of the seven-rights procedures in drug administration. This study aims to identify the inhibiting factors in the implementation of the seven-rights procedure in X Hospital as well as to obtain alternative solutions to those inhibiting factors. This study used a cross-sectional design. The data was gathered from 20 nurses at Hospital X using a questionnaire to measure the knowledge, attitude, and behaviour of nurses on the seven-rights procedure. The data is also supported by observation on the actual implementation of the procedures. At the end of the data gathering process, interviews with nurses in inpatient room were conducted to obtain their opinion about the obstacles in applying the seven-rights procedures. The results show that the main problem of drug administration errors was the lack of standard operating procedures (SOP) and nurses’ non-compliance behaviour on the seven-rights procedure. This study also reveals that there is no relationship between the nurses’ knowledge and their behaviour in applying the seven-rights procedures. To prevent medication error, the hospital manager should revise the SOP, conduct a periodic internal refreshment-workshop about the procedure, and perform scheduled supervision to the nurses.
LOSS OF LINEN STOCK AT RSIA PURI BUNDA: WHAT IS AFFECTING? DRIE, IVAN -; Ratri, Devita Rahmani; Nuthea, Merry -
Jurnal Kedokteran Brawijaya Article in Press 2
Publisher : Fakultas Kedokteran Universitas Brawijaya

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Abstract

The number of linens is insufficient, the cleanliness of the linen is lacking, and the inaccuracy of the time in linen services will affect the quality of hospital services. In addition, it has an impact on inefficient financing for linen needs and decreased patient satisfaction with linen services. Based on the results of research conducted at RSIA Puri Bunda Malang, it was found that there were still 108 linen incidents from the initial stock of linen 792. This research is a descriptive study that aims to find the root of the problem about what factors influence the loss of linen at RSIA Puri Bunda. From the results of the research conducted, there were several root problems that affected the missing linen in the inpatient unit, namely the absence of a hospital policy that regulated complete linen management techniques, weak evaluation monitoring, and inadequate linen management planning. The problem of the factors that influence the loss of linen in the inpatient unit of RSIA Puri Bunda Malang is the hospital management repairing and completing the existing linen management system or guidelines with a missing management monitoring and control system to make it more effective and efficient as well as strengthening the monitoring and evaluation functions under general manager coordination.
How Do Hospital Staffs Cope with Covid-19 at Work? A Phenomenological Study Febrianto, Wahyu; Indriani, Wiwin; Dewanto, Aryo; -, Holipah
Jurnal Kedokteran Brawijaya Article in Press 2
Publisher : Fakultas Kedokteran Universitas Brawijaya

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Abstract

The first confirmed Corona Virus Disease 2019 (Covid-19) case in Indonesia was found in March 2020 and rapidly spread out across all provinces. Covid-19 hit unexpectedly that almost all hospitals around the world were unprepared for it. Several studies show that Covid-19 impacts negatively on hospital finance, the mental health of healthcare workers (HCWs), and the death of HCWs. Hasta Brata Hospital (HBH) is one of the hospitals in East Java affected by the pandemic. Therefore, this study aims to investigate the experience of HBH staff face the issues. This study was qualitative research with a phenomenological approach. The data were collected using in-depth interviews with two HBH’s staff. ACovid-19 pandemic causes problems to the hospital, especially the staff. They experienced deep emotional and physical pressure at work, such as fear of infection, repeated conflict with patient's visitor, having different mindsets among staff, and increasing workload. The situation in the community is also frustrating them as the Covid-19 cases keep rising, while people tend to disobey the Covid-19 prevention protocols. Fortunately, they have proper job resource, started from physical support such as the provision of personal protective equipment, nutritional enhancement, and periodic Covid-19 screening; cognitive support such as knowledge update about Covid-19 and its handling methods; to psychological support such as motivational and spiritual support from the HBH leader. Moreover, they also pose strong personal resources that help them to cope with stressful working situations. They could, then, bounce back, feel optimistic that they could fight against Covid-19, with the hope that the pandemic will have an end. Continuous spiritual support gives them another personal resource of tawakkal, an Islamic concept of giving entire resignation and reliance on God only after exerting maximum effort. It seems that job resources and personal resources have succeeded in reducing the highly demanding situation and transform it into positive outcomes. Given a challenging situation, the hospital staffs strive to perform well and bring themselves into their work when providing patient care. Covid-19 pandemic forced the hospital and staff to adapt to the condition quickly. The presence of job resources and the provision of strong personal resources have succeeded in moderating job demands and resulting in positive outcomes. Tawakkal becomes an adding point on staff's personal resources that made them realize that Covid-19 is inevitable, and they have to fight back before finally giving their full resignation to God.
WHY INPATIENT VISITS DECREASED DURING THE PANDEMIC? CASE STUDY IN HOSPITAL X, MALANG REGENCY Lukito, Anggun Agatha Cristy; Widyaningrum, Kurnia
Jurnal Kedokteran Brawijaya Article in Press 2
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Abstract

ABSTRACTCovid-19, designated as a National disaster in Indonesia, has an impact on reducing the number of non-Covid-19 inpatient visits in almost all hospitals. Hospital X also underwent a decrease in inpatient visits, resulting in a decrease in the Bed Occupancy Rate (BOR) by 35,5%. The study aimed to identify the factors causing the decrease in the number of inpatients at Hospital X from April to July. This study used a qualitative descriptive approach with Focus Group Discussion (FGD) data collection techniques analyzed using Fishbone Diagram combined with 5 WHYs. The subjects were determined based on purposive sampling, namely 8 respondents consisting of the head of the inpatient room, the coordinator of the inpatient room, the outpatient coordinator, head of public relations and marketing unit, and the coordinator of the patient registration office. Through the Fishbone Diagram, there found several root cause themes covering 4 aspects, namely the Human aspect, the Method aspect, the Mother Nature or the Environment aspect  and the Market aspect as the cause of the decrease in the number of hospitalized patients at  Hospital X during the Covid-19 pandemic. 
Completeness of Medical Record Documents: Exploration of Causes and Solutions Syukria, Orin Annahriyah; Wardhani, Viera
Jurnal Kedokteran Brawijaya Article in Press 2
Publisher : Fakultas Kedokteran Universitas Brawijaya

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Abstract

One of the problems identified at X Hospital in the first six months of 2020 was the delay in returning inpatient medical records to the medical records unit. This study was conducted to explore the elements of the incomplete medical records and the factors that contribute to the emergence of delays in returning these documents. This study uses a qualitative method. Exploration was carried out on 21 medical records using a checklist. Besides, data were obtained through interviews involving the head of the relevant unit and a survey of 52 nurses. Data were collected using interview guidelines and nursing work index-revised (NWI-R) instruments. Incompleteness was found mostly in the patient discharge summary form, initial emergency assessment, and initial inpatient medical assessment. Items that have not been completed at most are officer authentication and information on date and time. One of the root causes of this problem is the factor of the nurse. The results of the NWI-R assessment are 3.15 (maximum value 4), which means that the work environment at X Hospital supports nurses in carrying out their duties well. The highest score is 3.31 on the nurse-doctor relationship factor. The lowest score is 2.93 on adequate human resources to ensure quality services.
Needs and Modification Analysis for X Hospital Dental Clinic Infrastructure in Response to Covid-19 Kurniawan, Gladys; Hakim, Lukman; Al Rasyid, Harun; Djauhari, Thontowi
Jurnal Kedokteran Brawijaya Article in Press 2
Publisher : Fakultas Kedokteran Universitas Brawijaya

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Abstract

This research was conducted to find the root of the problem and the solution to the inactivity of X Hospital Dental Clinic since the Covid-19 pandemic. The findings from the study are expected to be an input for the hospital to be able to immediately reopen Dental Clinic services. The research design used descriptive analysis of observation data, interviews, and literature study. The Fishbone Diagram combined with 5 WHYs is used to find the root of the problem. Determination of problem solutions using the CARL method (Capability, Accessibility, Readiness, and Leverage) through the Forum Group Discussion (FGD). The results showed that the root cause of the inactivity of X Hospital Dental Clinic since the Covid-19 pandemic was the unavailability of infrastructure in accordance with the minimum standards. Therefore, X Hospital needs to procure appropriate infrastructure and support the X Hospital Dental Clinic facilities in providing services during the Covid-19 pandemic. This procurement must be adjusted to the conditions of the space and environment around the Dental Clinic and the capabilities of the hospital. The proposed adjustment is a modification to the infrastructure that will be provided and the existing Dental Clinic facilities. The infrastructure that must be provided is related to air circulation, practice room management, and patient procedures.
THE COMMUNITY’S STIGMA CAUSE OF DECREASE VISITING “X” HOSPITAL IN COVID-19 PANDEMIC Megawati, Devvy; Erzi’, Alfan; Ratri, Devita Rahmani
Jurnal Kedokteran Brawijaya Article in Press 2
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Abstract

“X” hospital Tulungagung is a class D with madya accredited hospital in collaboration health BPJS. "X" hospital Tulungagung has a problem of decreasing the utilization bed in the Inpatient Unit during Covid-19 pandemic. These problems lead to decline of 32.5% income. Decreasing income has an impact on cash flow, increasing operating expenses, hospitals experiencing losses, and threatening the continuity of service operations. At "X" hospital Tulungagung the research aims to identify the root of problem and find the best solution based on the problem. The research at "X" hospital Tulungagung is mixed method research. Qualitative research method uses interviews and quantitative methods uses a questionnaire in totaling 164 samples with eta correlation test method. The results of the fishbone diagram analysis obtained the root of problem, namely community's stigma about Covid-19 pandemic and rapid test at the "X" Tulungagung hospital, Tulungagung Regency's had the policy for private hospitals not take care of Covid-19 patients, Prohibition to visiting families for inpatients, expensive operational costs of Covid-19 screening, and SDI's stigma regarding to care of Covid-19 patients. The most dominant root of problem is community's stigma about Covid-19 pandemic and rapid test at the "X" Tulungagung hospital. The efforts to enhance visits at "X" Tulungagung hospital, namely eliminating the stigma of society through the creation of an educational Starter Kit about Covid-19 protocol at "X" Tulungagung hospital, which is part of hospital health promotion.
FACTORS CAUSES OF STOCK OUT AND DRUG STAGNANT AT PHARMACY INSTALLATION OF HOSPITAL X MALANG Tri Utami, Ni Nyoman Ayu; Ratri, Devita Rahmani; Nuthea, Merry
Jurnal Kedokteran Brawijaya Article in Press 2
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Abstract

Hospital pharmacy service is a supporting service as well as a revenue center in the hospital. More than 90% of hospital services use pharmaceutical supplies and 50% of hospital revenues come from managing pharmaceutical supplies. In the Covid-19 pandemic situation, the Pharmacy Installation must calculating the logistics management of the medicine properly. However, based on the hospitalization stock in May-July at X Hospital, there was still an incidence of stock out of 4.06% and stagnation of 2.44% due to poor drug procurement, which caused drug sales to decline. This study aims to analyze the factors that causing drug stock outs and stagnation in the Pharmacy Installation of X Hospital. This study uses a descriptive approach with data collection methods through observation, Focus Group Discussion (FGD), and a Likert scale questionnaire to get the root of the problem. Then the data was analyzed using the Fishbone Diagram and Pareto Diagram. The research subjects based on total sampling were all 11 staff of the Pharmacy Installation. The results obtained through the Fishbone Diagram are 13 root causes covering aspects of Man, Money, Method, Machine, Material, and Environment. The priority of the root cause of drug stock outs and stagnation in the Pharmacy Installation of X Hospital, namely HMIS is not optimal. Solutions that can be given are conducting intensive training for Pharmacy Installation staff in the use of HMIS, developing HMIS related to drug procurement, as well as repairing warehouse and pharmacy installation facilities and infrastructure.
H2O2-Scavenging Activity and Hyaluronidase Inhibition Scutellarin and Apigenin in Basil Leaf Extract Lydia Yusuf; Ermi Girsang; Ali Napiah Nasution; Cut Elvira; Satrio Haryo Benowo Wibowo; Wahyu Widowati
Jurnal Kedokteran Brawijaya Vol. 31 No. 3 (2021)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2021.031.03.1

Abstract

The potential utilization of flavonoid compounds, especially scutellarin, and apigenin, contained in basil (Ocimum basilicum L.) leaf extract to manage the aging effects on the skin, that occurs because of over-activated hyaluronidase enzyme and oxidative stress due to hydrogen peroxide (H2O2) radicals, is not well known. This study was conducted to assess the H2O2 scavenging activity and the inhibition of hyaluronidase from scutellarin and apigenin at various concentrations. The study was conducted by measuring H2O2 scavenging inhibition and hyaluronidase inhibition of scutellarin and apigenin in various concentrations using the spectrophotometry method. The various activity was tested using the One-Way ANOVA test followed by Tukey post hoc test. IC50 values were calculated based on linear regression equations of H2O2 scavenging inhibition and hyaluronidase inhibition. The analysis showed the highest H2O2 scavenging activity was found in scutellarin with IC50 158.76 μg/mL. Scutellarin has greater scavenging activity than apigenin. Hyaluronidase inhibition of scutellarin with IC50 35.25 µg/mL, while apigenin was 162.86 µg/mL. Scutellarin has higher hyaluronidase inhibition activity than apigenin. Antioxidant and antiaging effects of basil leaf extract caused by phytochemical compounds contained, especially scutellarin.
Correlation between Chronic Kidney Disease Severity and Cognitive Function Epa Danisa Surbakti; Fasihah Irfani Fitri; Aldy Safruddin Rambe
Jurnal Kedokteran Brawijaya Vol. 31 No. 3 (2021)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2021.031.03.2

Abstract

Chronic kidney disease (CKD) is an independent risk factor for cognitive impairment in all domains, especially delayed memory and executive function. The purpose of this study was to determine the correlation between chronic kidney disease severity and cognitive function. This study used a cross-sectional design in stage III, IV, and V CKD patients in the Nephrology Polyclinic of Haji Adam Malik Central General Hospital. Cognitive function tests were performed using the Montreal Cognitive Assessment (MoCA INA), digit span, and Trail Making Test A & B. The Spearman test was used to analyze the correlation between CKD severity and cognitive function. This study involved 45 chronic kidney disease patients consisting of 28 (62.2%) males and 17 (37.8%) females with a mean age of 49.67±12.18 years. The results of statistical analysis showed that there was a significant positive correlation between CKD on the MoCA-INA examination (r=0.618, p=<0.001), FDS (r=0.414, p=0.005), there was a significant negative correlation on the TMT A time examination (r=-0.425, p=0.004), TMT A error (r=-0.497, p=0.001), TMT B time (r=-0.618, p=<0.001), TMT B error (r=-0.370, p=0.012). The results of this study prove a significant correlation between the severity of CKD and cognitive function.

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